Sondra Lavigne is a PhD candidate in epidemiology and veterinary science at the University of Pennsylvania. She is part of the Health Policy Research Scholars (HPRS) Cohort 2016.
Before we begin, tell us a little bit about yourself and what your research interests are.
I grew up in a small rural community in western Maryland and have always been interested in science. I received a bachelor’s degree in organismic and evolutionary biology at Harvard University, and a few years later I was accepted into the Veterinary Medical Scientist Training Program at the University of Pennsylvania. I’ve always been interested in the intersection of animal and human health, so working toward a veterinary medical degree (VMD) at the veterinary school and a PhD in epidemiology at the School of (human) Medicine has been a rewarding experience. My primary research interest is antibiotic use and resistance, both in people and animals. Antibiotics are a precious resource, and in order to preserve their effectiveness, we need to consider polices that impact people, animals, and the environment.
What’s the story behind why you’re doing what you’re doing?
I remember sitting in my second-year veterinary microbiology course and learning about antibiotic resistance in veterinary medicine. We were told that some infections that had been easily treated in the past were becoming more and more difficult to treat and that infections could resist treatment with antibiotic drugs. We also learned that some bacteria can infect humans and animals alike. I started thinking about the possible implications for human and veterinary health. My friends and I certainly snuggled and cuddled with pets. Many of us ate animal products. Farmers in my hometown worked with livestock daily. How can antibiotic resistance in humans impact animals and vice versa?
Although there were some collaborations between the medical schools and veterinary schools, antibiotic resistance research mostly took place in silos. I saw an opportunity to train with and combine resources from the medical and veterinary schools to try to more holistically understand this issue in terms of the connections between human and animal health.
Tell us about a project you are currently working on that you are excited about?
I’m really excited about an in-depth interview study I’m conducting with veterinarians. I’m interested in what goes through their minds when they’re making decisions about whether or not to prescribe antibiotics to their animal patients. We know that antibiotic use is the greatest driver of antibiotic resistance and that many antibiotics (in human and veterinary medicine) are prescribed unnecessarily. We’re hoping that by learning more about how veterinarians think about and prescribe antibiotics, we can identify some ways policies could help improve prescribing. I’ve really enjoyed the process of conducting this study and am excited to share our findings soon.
For people unfamiliar with your research area, what is one piece of information you think is important for them to know?
Antibiotics are a limited resource, and they can do harm when used unnecessarily. From both a public and an individual health standpoint, it’s important for every person to know that antibiotics cannot treat viral infections like colds or the flu. Whether you’re going to the doctor yourself or bringing your pet to the vet, it’s OK to question your doctor on the issue of antibiotic resistance. Ask them whether antibiotics are needed and appropriate or whether alternative treatments or therapies exist.
Who is a researcher you admire and why?
I really admire Julia Szymczak, an Assistant Professor in Epidemiology at the University of Pennsylvania and one of my mentors. She’s a sociologist working in a medical department and is making important contributions to public health. I value the interdisciplinary nature of her work. She took the time to train me in qualitative research, and my veterinary interview study is based on her work with MDs in both adult and pediatric settings. Her research has direct implications for the development of policies to reduce the spread of infectious diseases. I hope that my work can have a similar effect in veterinary medicine someday.
How has being an HPRS Scholar helped you during your time as a doctoral candidate?
The support, both personal and financial, is amazing. Typically students in my department will develop a dissertation topic that allows them to be funded through their mentor’s existing grants. As a veterinary student working in a medical school, I found it hard to find existing projects that fit my interest. The funding from HPRS gave me the freedom to work with my primary mentor, Dr. Theo Zaoutis, to bring together an interdisciplinary mentorship team and build a research project that focused on the intersection of human and animal health.
Just as—if not more—important is the support I receive from the HPRS team and all my fellow scholars. When any of us is having a tough time, the others are there to help us work through any problems and give us emotional support. I’ve never met a group of more caring and passionate people.
In the RWJF HPRS program, we have worked with you to help you think further about using your research to develop policy. If you could use your research to change any policy, what policy would it be?
I would use my research to help develop policies targeted at supporting veterinarians in efforts to implement antibiotic stewardship plans in both agriculture and companion animal medicine. Stewardship plans include education for prescribers and the public, tracking of antibiotic use and resistance, accountability measures for hospital leadership, and evidence-based interventions to reduce unnecessary prescribing. While antibiotic stewardship plans in human hospitals across the United States have reduced antibiotic-resistant bacteria and the inappropriate use of antibiotics in human medicine, these policies are still developing in veterinary hospitals and agriculture. Some antibiotic-resistant bacteria can move between humans, animals, and the environment, and we really need to change practices and track progress in agriculture and veterinary medicine as well as human medicine to address it fully.
OK, here’s a fun question to wrap things up. If you could visit any place in the world, where would you choose to go and why?
I would go back to Tanzania, where I spent a semester abroad in undergrad. It was my first time abroad and a phenomenal experience. I would love to bring my family, especially my 3-year-old son, with me this time and introduce them to my homestay family from my first trip.
